Roles of Chaplains and Clergy in Spiritual Care for African Americans in Hospice: A Pilot Study.

CONTEXT: Spiritual care is recognition of patient and caregiver spiritual/religious needs and attention to those needs. Caregivers of African American hospice patients are more likely to report worse emotional/religious support. Yet, spiritual care delivery and roles of community clergy and chaplains for African American hospice patients are not well understood. OBJECTIVES: Examine who provides spiritual care to African American hospice patients and caregivers. METHODS: Partnering with large, urban/suburban community hospice, we interviewed caregivers of deceased African American hospice patients (n = 12), their clergy (n = 3) and chaplains (n = 5). Using a phenomenological qualitative study design, we coded transcripts and deceased patient chart data and conducted thematic analysis to identify themes. RESULTS: Community clergy and chaplains tend to not interact and provide different aspects of emotional, religious and spiritual support to hospice patients and families. Clergy and chaplains agreed that rapport and openness of the patient were main factors in meeting spiritual care needs. Clergy provided interaction with a trusted person and connection to church, congregational support, religious beliefs/theology, and practices. Chaplains focused on present needs and issues of death and dying. CONCLUSION: Clergy and chaplains have distinct, complementary roles in providing spiritual care to African American hospice patients and families. Both are needed to provide desired spiritual care for African American hospice patients and their caregivers. Robust spiritual care programs need to ensure chaplains have sufficient time to spend with patients and families and incorporate collaboration, handoffs and integrated processes for clergy and chaplains. Research is needed on effectively including clergy in hospice spiritual care delivery.

Dermatological Implications of the Taqiyah and Imamah: Recommendations for Delivering Culturally Conscious Care.

Background and objective The growing cultural and religious diversity in healthcare settings necessitates clinicians to integrate cultural competence and sensitivity into their practice. Despite significant research focusing on the hijab worn by Muslim women, there is a gap in understanding the dermatological implications of the taqiyah and imamah, worn by Muslim men. In light of this, this study aimed to offer insights into delivering culturally conscious dermatological care for Muslim men wearing these garments, thereby bridging a crucial knowledge gap. Materials and methods The study employed a comprehensive research strategy that encompassed both medical literature and foundational Islamic texts. PubMed, Web of Science, and Scopus were used for medical literature searches, while al-Maktabah al-Shamela and Sunnah.com, along with Quranic and Hadith translations were consulted for religious insights. A thematic analysis was employed to identify patterns, challenges, and unique points, ensuring a holistic understanding of the subject. Results Our findings revealed that wearing a taqiyah or imamah has both beneficial and detrimental dermatological effects, depending on factors such as climate, fabric, and hygiene practices. While the garments are rooted in Islamic tradition, their use varies based on cultural context rather than strict religious guidelines. Moreover, gender dynamics and the concept of privacy ('awrah) within Islamic teachings have implications for healthcare interactions. The study offers practical guidelines for dermatological care tailored to Muslim men wearing a taqiyah or imamah. It emphasizes the importance of material choice, hygiene practices, and the willingness of many Muslim men to be accommodating in medical settings, albeit with some reservations. The paper also discusses the role of telemedicine in culturally sensitive healthcare delivery, recommending measures such as secure communication channels and self-imaging options. Conclusion The paper provides comprehensive recommendations aimed at delivering culturally and religiously sensitive dermatological care to Muslim men wearing a taqiyah or imamah. By integrating both medical best practices and a nuanced understanding of Islamic customs, healthcare providers can foster a more trusting and effective care relationship, thereby improving patient satisfaction and dermatological outcomes.

Perceived Neighborhood Disorder, Self-Esteem, and the Moderating Role of Religion.

A growing body of work links neighborhood conditions -and particularly perceived neighborhood disorder-with diverse aspects of psychosocial functioning, including self-esteem or the global moral self-worth of the individual. Our work augments this literature by investigating the possible roles of (a) organizational religiosity (i.e., religious attendance, religious support), (b) non-organizational religiosity (i.e., prayer and religious coping practices), and (c) the sense of divine control as potential stress in mitigating the deleterious effects of neighborhood disorder on self-esteem. Data from the Nashville Stress and Health Study (NSAHS, 2011-2014) are used to test a series of hypotheses regarding the possible stress-buffering effects of multiple religious domains. Findings from multivariable regression models indicate that: (a) perceived neighborhood disorder is inversely associated with self-esteem; (b) non-organizational religiosity and the sense of divine control each mitigate this pattern; and, interestingly, (c) organizational religiosity does not buffer the association between neighborhood disorder and self-esteem. Several study limitations, as well as a number of promising directions for future research, are identified.

The Influence of Culture, Social, and Religious Support on Well-Being in Breast Cancer Survivorship.

Objective Latina and African American breast cancer survivors (BCS) are affected by health disparities that have negatively impacted their health outcomes and quality of life more than other BCS. Examining the relationships among social support, culture, and well-being in underserved groups may help clarify critical factors that influence health disparities in cancer survivors. Methodology Ethnic salience (impact of ethnicity on identity), religious support, social support, and well-being were examined in African American and Latina breast cancer survivors using archival data. Participants included 320 breast cancer survivors (28% African American and 72% Latina) ranging from 26-89 years old and one to five years post breast cancer diagnosis. Results Ethnic salience was positively associated with well-being (p < .001). African American breast cancer survivors endorsed greater well-being, social support, religious support, and ethnic salience than Latinas (ps < .05). Religious support was associated with well-being even after controlling for the effects of general social support [ΔR 2 = .02, p = .005; F(5, 298) = 23.67]. Conclusion Ethnic salience and religious support are important factors in understanding health disparities and should inform survivorship care plans for underserved populations.

Religious Support Moderates the Long Reach of Adverse Childhood Events on Physical Health in Middle to Late Adulthood.

Adverse childhood experiences are associated with impaired physical health in adulthood. Using data from the Midlife in the United States survey (N = 4041), this study examined whether four dimensions of religiosity moderated the long-term detrimental effects of early adversity on three distinct aspects of adult physical health (self-rated health, functional limitations, and shortness of breath). Regression analyses showed that religious support buffered the effect of childhood adversity on physical health, but religious identification, private religious practice, or religious service attendance did not. Results imply that interventions aimed at increasing religious support can be effective decades after the adverse experiences took place.

Relationship between Religious Support and Major Depressive Episode for Adult Non-Medical Prescription Opioid Users and Non-Users.

Background: Non-medical prescription opioid use (NMPOU) is linked with poor mental health outcomes. Previous research has shown that religious support is protective for mental health. Objectives: To fill the gap in knowledge about how to assist NMPOU users decrease or prevent depression symptoms by incorporating religious support and to identify whether the suppressor model or the health effects model reflects the relationship between religious support and major depressive episode (MDE) for NMPOU users. Methods: Data from the 2016 National Survey on Drug Use and Health were analyzed for 42,625 adults aged 18 years and older. Weighted binary logistic regression analyses were conducted using STATA 15 to examine the odds of NMPOU and religious support on MDE, all within the past year. Results: NMPOU was associated with increased odds of having a past-year MDE (OR = 2.99, 95% CI: 2.47, 3.62). Two significant associations were found among non-users: (a) between MDE and the importance of one's religious beliefs (OR = 0.78, 95% CI: 0.64, 0.94) and (b) between MDE and sharing one's religious beliefs with friends (OR = 0.66, 95% CI: 0.56, 0.78). However, the association of religious support and MDE among NMPOU users was not statistically observed. Conclusions: Religious support from friends and believing religious beliefs are essential in life appeared to be protective factors against MDE among non-users. Further research is needed to explore protective factors that can effectively address the association between opioid misuse and mental health and be incorporated into health interventions targeting the opioid epidemic.

Religion Affiliation and Depression Risk: Factory Workers Working in Hi-Tech Companies in Shanghai, China.

This study examines factors contributing to depression among migrant factory workers in Shanghai. A survey was designed with mental health questions under a framework explaining: (1) social capital, (2) migratory stress, and (3) mental health consequences. With a return rate of 98.3%, 1966 individuals completed the survey. Only 11.1% of the respondents indicated having a religious affiliation. The findings are not surprising about the relationship between trust, economic condition, and depression. However, it is surprising to find that not having a religious affiliation is significantly connected to better mental health. The effect of religious beliefs should be examined as a trust factor to remove the barrier of perceiving religion as an added stressor.

Assistência religiosa-espiritual hospitalar: os "porquês" e os "comos" / Hospital religious-spiritual assistance: the "whys" and the "hows"

A relação entre religiosidade-espiritualidade e a saúde física e mental adquire uma importância maior para pacientes internados em um hospital. Assim, os serviços de internação devem investir em ações que possam apoiar os recursos religiosos-espirituais e buscar formas para atender estas necessidades especiais. A assistência religiosa-espiritual hospitalar (AREH) se refere à atenção profissional aos mundos espirituais e religiosos subjetivos dos pacientes, mundos compostos de percepções, suposições, sentimentos e crenças sobre a relação do sagrado com sua doença, hospitalização e recuperação ou possível morte. Há pelo menos cinco razões para que uma instituição invista em um programa de AREH: 1. o bem-estar religioso-espiritual é prioritário durante uma internação; 2. a apreciação religiosa-espiritual é um padrão para a acreditação hospitalar; 3. pode desfazer mal-entendidos religiosos-espirituais que afetariam o tratamento; 4. os pacientes querem uma perspectiva religiosa-espiritual da instituição; e 5. os custos poderiam ser reduzidos com apoio religioso-espiritual. As formas de se oferecer AREH podem ser de modo individual ou coletivo; pode ser focado em uma denominação religiosa específica ou ser multifé. O apoio em um nível básico pode ser da alçada dos profissionais de saúde e, em um nível crescente de especialização, pode ser oferecido por um voluntário treinado, por um ministro religioso da comunidade ou por um capelão hospitalar. O público-alvo da AREH inclui não apenas o paciente internado, mas também seus familiares, seus cuidadores e os profissionais de saúde. Apesar da existência de leis que garantam o acesso do interno ao apoio religioso, o Brasil não possui regulamentação para a profissionalização desta atividade. O presente artigo explora todos os conceitos anteriores e descreve o que se espera de um programa de AREH.

The relationship between religiosity-spirituality and physical and mental health assumes greater importance for hospital inpatients. Thus, inpatient services should invest in actions that can support religious-spiritual resources and seek ways to address these special needs. Religious-spiritual hospital care (assistência religiosa-espiritual hospitalar - AREH) refers to the professional attention to the subjective spiritual and religious worlds of patients, worlds composed of perceptions, assumptions, feelings and beliefs about the relationship of the sacred with his/her illness, hospitalization and recovery or possible death. There are at least five reasons for an institution to invest in an AREH program: 1. Religious-spiritual well-being is yet higher priority during hospitalization; 2. Religious-spiritual appreciation is a standard for hospital accreditation; 3. It can undo religious-spiritual misunderstandings that would affect treatment; 4. Patients want a religious-spiritual perspective from the institution; and 5. Costs could be reduced with religious-spiritual support. The forms of offering AREH can be as individual or collective way; can be focused on a specific religious denomination or be multi-faith. Support at a basic level may be the responsibility of health professionals and, as the level of complexity increases, may be provided by a trained volunteer, community religious minister, or hospital chaplain. The target audience of the AREH includes not only the inpatient, but also their relatives, caregivers and health professionals. Despite the existence of laws that guarantee the inpatients access to religious support, Brazil does not have regulations for the professionalization of this activity. This article explores all the above concepts and describes what is expected from an AREH program.

Urban ministry workers' positive experiences of interpersonal and religious support during crisis.

Research on faith-based urban workers is limited despite the chronic and traumatic exposure inherent in their work. This study details the perception of positive interpersonal relationships during a time of trauma or crisis as described in semistructured 2- to 3-hour interviews with 13 faith-based urban workers in Los Angeles, California. Using strategies consistent with Consensual Qualitative Research, categories and subcategories defining positive interpersonal relationships were identified. Resulting categories suggested that there are specific characteristics, products, and types of relationships that urban workers experience as important during the time of trauma or crisis. Positive experiences were often religious in nature and included feeling supported, feeling connected, relationship growth, sharing and listening, authenticity, and feeling as through relationships facilitated personal growth or coping. The findings highlight participants' need for both practical support and relational support which reflects and enhances their spiritual commitment.

Dimensions of religious involvement and leukocyte telomere length.

Although numerous studies suggest that religious involvement is associated with a wide range of favorable health outcomes, it is unclear whether this general pattern extends to cellular aging. In this paper, we tested whether leukocyte telomere length varies according to several dimensions of religious involvement. We used cross-sectional data from the Nashville Stress and Health Study (2011-2014), a large probability sample of 1252 black and white adults aged 22 to 69 living in Davidson County, TN, USA. Leukocyte telomere length was measured using the monochrome multiplex quantitative polymerase chain reaction method with albumin as the single-copy reference sequence. Dimensions of religious involvement included religiosity, religious support, and religious coping. Our multivariate analyses showed that religiosity (an index of religious attendance, prayer frequency, and religious identity) was positively associated with leukocyte telomere length, even with adjustments for religious support, religious coping, age, gender, race, education, employment status, income, financial strain, stressful life events, marital status, family support, friend support, depressive symptoms, smoking, heavy drinking, and allostatic load. Unlike religiosity, religious support and religious coping were unrelated to leukocyte telomere length across models. Depressive symptoms, smoking, heavy drinking, and allostatic load failed to explain any of the association between religiosity and telomere length. To our knowledge, this is the first population-based study to link religious involvement and cellular aging. Although our data suggest that adults who frequently attend religious services, pray with regularity, and consider themselves to be religious tend to exhibit longer telomeres than those who attend and pray less frequently and do not consider themselves to be religious, additional research is needed to establish the mechanisms underlying this association.

Religion as problem, religion as solution: religious buffers of the links between religious/spiritual struggles and well-being/mental health.

PURPOSE: Previous studies have established robust links between religious/spiritual struggles (r/s struggles) and poorer well-being and psychological distress. A critical issue involves identifying the religious factors that buffer this relationship. This is the first study to empirically address this question. Specifically, it examines four religious factors (i.e., religious commitment, life sanctification, religious support, religious hope) as potential buffers of the links between r/s struggle and one indicator of subjective well-being (i.e., happiness) and one indicator of psychological distress (i.e., depressive symptoms). METHOD: We utilized a cross-sectional design and a nationally representative sample of American adults (N = 2140) dealing with a wide range of major life stressors. RESULTS: We found that the interactions between r/s struggle and all potential moderators were significant in predicting happiness and/or depression. The linkage between r/s struggle and lower levels of happiness was moderated by higher levels of each of the four proposed religious buffers. Religious commitment and life sanctification moderated the ties between r/s struggles and depressive symptoms. CONCLUSIONS: The findings underscore the multifaceted character of religion: Paradoxically, religion may be a source of solutions to problems that may be an inherent part of religious life.

Political violence, health, and coping among Palestinian women in the West Bank.

Political violence poses a considerable threat to the health of individuals. Protective factors, however, may help people to build resilience in the face of political violence. This study examined the influence of lifetime and past 30-day experiences of political violence on the mental and physical health of adult Palestinian women from the West Bank (N = 122). Two hypotheses were examined: (a) Reports of political violence exposure would be related to reports of poorer physical and mental health and (b) several coping variables (proactive coping; self-reliance; reliance on political, family, and religious support; and political or civic engagement) would function as moderators of the effects of political violence, buffering or weakening its effects on physical and mental health outcomes. Both lifetime and past 30-day measures of political violence were positively correlated with posttraumatic stress disorder symptoms. Proactive coping, reliance on self, and political or civic engagement significantly interacted with political violence to affect health in a counterintuitive direction; those with higher scores on these more internalized and individualistic coping strategies demonstrated worse health as political violence increased. Reliance on religious support, and, in particular, support from and participation in activities of religious institutions, emerged as a significant protective factor. Results underscore the importance of looking not only at whether political violence affects health, but also at how the relationships between political violence and health might occur, including the potential protective influence of resources within people's social environments.